Exploring Additional Medicaid BuyIn Data

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Exploring Additional Medicaid Buy-In Data

• Mike Baldwin
• Minnesota Department of Human Services

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Session Topics

• Standardizing Disability Type Classification
  Using Medicaid Claims Data For State-to-State
  Comparisons
• Data Analysis and Policy Decision-Making

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Standardizing Disability Type Classification

• Developed by Robert Keith, Muskie School of
  Public Service
• Uses Medicaid claims data (with an emphasis on
  ICD-9 diagnosis codes) to identify broad
  disability types
• Physical Disability
• Mental Illness
• Mental Retardation
• Though still in a development and testing phase,
  it is hoped that this concept will allow
  meaningful comparisons between states

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Standardizing Disability Type Classification

• Ideally, the exclusive use of Medicaid claims
  data will allow states to approximate each
  others logic closely
• The logic consists of three levels of Medicaid
  claims data searches. The logic can be applied
  hierarchically (one disability type per person)
  or in an overlapping fashion (the possibility
  of multiple disability types per person)

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Standardizing Disability Type Classifications

• Level I Search Criteria
• Mental illness and physical disabilities ICD-9
  diagnosis codes that indicate a per se disabling
  condition from the U.S. Health and Human
  Services report, Private Payers Serving
  Individuals with Disabilities and Chronic
  Conditions
• For mental retardation, ICD-9 diagnosis codes for
  moderate, severe, or profound mental retardation

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Standardizing Disability Type Classifications
Preliminary comparison of hierarchical disability
type classification of adult Medicaid disabled
population between Minnesota and Maine using
Level I search criteria
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Standardizing Disability Type Classifications

• Level II Search Criteria
• Mental Illness Antipsychotic medications
  waivers and categories of service for persons
  with mental illness diagnoses of substance abuse
• Physical Disabilities Waivers and categories of
  service for persons with physical disabilities
• Mental Retardation Waivers and categories of
  service for persons with mental retardation and
  related conditions

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Standardizing Disability Type Classifications
Preliminary comparison of hierarchical disability
type classification of adult Medicaid disabled
population between Minnesota and Maine using
Level II search criteria
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Standardizing Disability Type Classifications

• Level III Search Criteria
• Mental Illness any ICD-9 diagnosis code for
  mental illness (except sexual deviance and
  non-dependent abuse of drugs)
• Physical Disabilities ICD-9 diagnosis codes that
  indicate an activity limiting condition from
  the U.S. Health and Human Services report,
  Private Payers Serving Individuals with
  Disabilities and Chronic Conditions
• Mental Retardation diagnosis of unspecified or
  mild mental retardation, or a diagnosis of Downs
  Syndrome

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Standardizing Disability Type Classifications
Preliminary comparison of hierarchical disability
type classification of adult Medicaid disabled
population between Minnesota and Maine using
Level III search criteria
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Standardizing Disability Type Classifications
Preliminary comparison of overall hierarchical
disability type classification of adult Medicaid
disabled population between Minnesota and Maine
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Data Analysis and Policy Decision Making

• Empirical data analysis helps in the process of
  developing policy and measuring the effects of
  policy after it has been implemented it can be
  useful to project and evaluate things like
• Costs
• Enrollment Trends
• Medicaid Utilization

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Data Analysis and Policy Decision Making
Example Considering the earnings levels of
Medicaid Buy-In enrollees with concurrent Day
Training and Habilitation service agreements in
advance of a policy proposal requiring at least
65 average monthly earnings to remain on the
program to project how many from this group might
lose eligibility
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Sources

• Ozminkowski, Ronald J. et al. Private Payers
  Serving Individuals with Disabilities and Chronic
  Conditions. Washington D.C. The Medstat Group,
  under contract with The U.S. Department of Health
  and Human Services 2000. 12
  January 2004. lthttp//www.aspe.hhs.gov/daltcp/rep
  orts/privpay.htmTocgt